Using Systems Thinking for Translating Evidence into Practice: A Case Study of Embedding Shared Decision Making within a Federally Qualified Health Center Network

The following is a mixed-methods case study that examines how Access Community Health Network (ACCESS), a large federally qualified health center located in the Chicago metropolitan area, used a systems approach to incorporate Shared Decision Making into its practice model. Using both qualitative and quantitative methods including a survey of ACCESS staff and providers, as well as interviews with a range of providers and leadership, the study sought to answer the question: How successfully has ACCESS, as a complex primary care system, made Shared Decision Making an integral part of its Patient Centered Medical Home practice model?

With a high degree of consistency across both the survey and interview data, the study concludes that ACCESS has successfully shifted its culture towards Shared Decision Making and, over the course of the past several years, made it a part of its PCMH practice model. At the same time, there are still areas for improvement and ways that ACCESS can further embed SDM within its practice model. Opportunities exist to use this study as a foundation for further exploring the impact of SDM on patients and health outcomes (not a part of this study). Further, the results can be used by other complex health systems as a model for how to successfully integrate and translate best practice or innovation into care models.